Organization
CTVSA WISCONSIN S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATROKLOS STEVEN PAPPAS M.D. (PRESIDENT)
(708) 346-4040
Entity
Organization
Contact information
Practice address
6308 8TH AVE, SUITE 3060, KENOSHA, WI 53143-5031
(262) 656-2700
(262) 656-3672
Mailing address
4400 W 95TH ST, SUITE 205, OAK LAWN, IL 60453-2654
(708) 346-4040
(708) 346-3287
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
WI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
WI
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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